Management of Liver Abscess in Children: Our Experience.

Mukta Waghmare,Charu Tiwari,Kiran Khedkar,Suraj Gandhi,Hemanshi Shah

doi:10.5005/jp-journals-10018-1206

Abstract

Introduction:Liver abscess is common in pediatric population in India. Children have unique set of predisposing factors and clinical features. Liver abscesses are infectious, space-occupying lesions in the liver; the two most common abscesses being pyogenic and amebic. Its severity depends on the source of the infection and the underlying condition of the patient.Materials and methods:A total of 34 patients less than 12 years were assessed in a retrospective study from January 2012 to 2016. Patients were assessed in terms of age of presentation, etiology, bacteriology, diagnosis, and modality of treatment.Results:The mean age of presentation was 6.3 years. Average volume of abscess was 164 cc. Nine patients (26.4%) underwent percutaneous needle aspiration under ultrasound guidance with wide bore needle (18 G disposable needle). Three patients required more than two sittings of aspiration. Patients with volume more than 80 cc were treated with catheter drainage. Twenty patients (58.8%) underwent ultrasound-guided percutaneous catheter drainage. Two patients required catheter drainage for large abscess and needle aspiration for the smaller abscess.Conclusion:Antimicrobial therapy along with percutaneous drainage constitutes the mainstay of treatment, whereas open surgical drainage should be reserved for selected cases.How to cite this article: Waghmare M, Shah H, Tiwari C, Khedkar K, Gandhi S. Management of Liver Abscess in Children: Our Experience. Euroasian J Hepato-Gastroenterol 2017;7(1):23-26.

Highlights

Liver abscess is common in pediatric population in India
Patients with volume more than 80 cc were treated with catheter drainage
Antimicrobial therapy along with percutaneous drainage constitutes the mainstay of treatment, whereas open surgical drainage should be reserved for selected cases

Summary

Introduction

Liver abscess is common in pediatric population in India. Children have unique set of predisposing factors and clinical features. Space-occupying lesions in the liver; the two most common abscesses being pyogenic and amebic. Its severity depends on the source of the infection and the underlying condition of the patient. Liver is a major organ with dual blood supply, which predisposes it to an increased risk of infection. The incidence of pyogenic liver abscess (PLA) has decreased in the developed world, but it is still common in developing countries.[1] Two common liver abscesses are pyogenic and amebic. The PLA may be of biliary, portal, arterial, traumatic, or cryptogenic in origin

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